三角線維軟骨複合体損傷における尺側手根伸筋腱と遠位橈尺関節のMRI画像分析

BACKGROUND: We compared the incidence of extensor carpi ulnaris (ECU) tendon and distal radioulnar joint (DRUJ) abnormalities using magnetic resonance imaging (MRI) between patients with triangular fibrocartilage complex (TFCC) tears and subjects without ulnar wrist pain. Additionally, we aimed to identify potential predictors of these MRI lesions. METHODS: The TFCC group comprised 70 consecutive patients with TFCC tears. The control group comprised 70 age- and sex-matched subjects without ulnar wrist pain. We evaluated the presence or absence of fluid collection in the DRUJ and ECU peritendinous area and longitudinal ECU tendon splitting. Dimensions of the fluid collection area around the ECU tendon were measured to evaluate the severity. The incidences of these abnormal MRI findings were compared between the two groups. We analyzed the correlation between the presence of ECU tendon and DRUJ lesions and variables including age, magnitude of ulnar variance, and type of TFCC tear. RESULTS: Significant differences were found between the two groups in the incidence of fluid collection of the DRUJ and ECU peritendinous area, and longitudinal ECU tendon splitting. Among the 70 patients with TFCC tears, age and the magnitude of ulnar variance were significantly correlated with the severity of fluid collection around the ECU tendon. The magnitude of ulnar variance in patients with DRUJ fluid collection was significantly larger than that in patients without fluid collection. There was a significant correlation between the presence of disc tears and DRUJ fluid collection. CONCLUSION: We found a higher incidence of accompanying abnormal MRI findings of the ECU tendon and DRUJ in patients with TFCC tears than in the control group. The presence of disc tears, the magnitude of ulnar variance, and age may be risk factors for these MRI lesions associated with TFCC tears.博士（医学）・甲第690号・平成30年11月30日Copyright © 2018 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved

三角線維軟骨複合体損傷における尺側手根伸筋腱と遠位橈尺関節のMRI画像分析

BACKGROUND: We compared the incidence of extensor carpi ulnaris (ECU) tendon and distal radioulnar joint (DRUJ) abnormalities using magnetic resonance imaging (MRI) between patients with triangular fibrocartilage complex (TFCC) tears and subjects without ulnar wrist pain. Additionally, we aimed to identify potential predictors of these MRI lesions. METHODS: The TFCC group comprised 70 consecutive patients with TFCC tears. The control group comprised 70 age- and sex-matched subjects without ulnar wrist pain. We evaluated the presence or absence of fluid collection in the DRUJ and ECU peritendinous area and longitudinal ECU tendon splitting. Dimensions of the fluid collection area around the ECU tendon were measured to evaluate the severity. The incidences of these abnormal MRI findings were compared between the two groups. We analyzed the correlation between the presence of ECU tendon and DRUJ lesions and variables including age, magnitude of ulnar variance, and type of TFCC tear. RESULTS: Significant differences were found between the two groups in the incidence of fluid collection of the DRUJ and ECU peritendinous area, and longitudinal ECU tendon splitting. Among the 70 patients with TFCC tears, age and the magnitude of ulnar variance were significantly correlated with the severity of fluid collection around the ECU tendon. The magnitude of ulnar variance in patients with DRUJ fluid collection was significantly larger than that in patients without fluid collection. There was a significant correlation between the presence of disc tears and DRUJ fluid collection. CONCLUSION: We found a higher incidence of accompanying abnormal MRI findings of the ECU tendon and DRUJ in patients with TFCC tears than in the control group. The presence of disc tears, the magnitude of ulnar variance, and age may be risk factors for these MRI lesions associated with TFCC tears.博士（医学）・甲第690号・平成30年11月30日Copyright © 2018 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved

尺骨偽関節に対する前骨間動脈を血管茎とした橈骨遠位からの有茎血管柄付き骨移植：解剖学的研究と症例報告

Background: A vascularized distal radius graft can be a reliable solution for the treatment of refractory ulnar nonunion. The aim of this study is to establish the anatomical basis of a vascularized bone graft pedicled by the anterior interosseous artery and report its clinical application, using cadaveric studies and a case report. Methods: Fourteen fresh frozen cadaveric upper limbs were used. The branches of the anterior interosseous artery (the 2, 3 intercompartmental supraretinacular artery and the fourth extensor compartment artery) were measured at the bifurcation site. The anatomical relationship between the anterior interosseous artery and motor branches of the posterior interosseous nerve was investigated. An anterior interosseous artery pedicled bone flap was used in a 48-year-old woman with refractory ulnar nonunion. Results: There were two variations depending on whether the 2,3 intercompartmental supraretinacular artery branched off distally or proximally from the terminal motor branch of the posterior interosseous nerve. The proximal border of the graft was located at an average of 10.5 cm (range, 6.5-12.5 cm) from the distal end of the ulnar head in the distal type (57%) and 17.5 cm (range, 9.5-21.5 cm) in the proximal type (43%). In the clinical application, successfully consolidation was achieved 4 months post-surgery. The patient had not developed any postoperative complications until the 2-year postoperative follow-up. Conclusions: The anterior interosseous artery-pedicled, vascularized distal radius bone graft would be a reliable alternative solution for the treatment of an ulnar nonunion located within the distal one-third of the ulna.博士（医学）・甲第767号・令和3年3月15日© 2020 Wiley Periodicals, Inc.This is the peer reviewed version of the following article: https://onlinelibrary.wiley.com/doi/full/10.1002/micr.30566, which has been published in final form at https://doi.org/10.1002/micr.30566. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions

肘の内外反変形に伴う尺骨神経の伸長度変化に関する生体力学的研究

Background: Cubital tunnel syndrome can be caused by overtraction and dynamic compression in elbow deformities. The extent to which elbow deformities contribute to ulnar nerve strain is unknown. Here, we investigated ulnar nerve strain caused by cubitus valgus/varus deformity using fresh-frozen cadavers. Methods: We used six fresh-frozen cadaver upper extremities. A strain gauge was placed on the ulnar nerve 2 cm proximal to the medial epicondyle of the humerus. For the elbow deformity model, osteotomy was performed at the distal humerus, and plate fixation was performed to create cubitus valgus/varus deformities (10°, 20°, and 30°). Ulnar nerve strain caused by elbow flexion (0–125°) was measured in both the normal and deformity models. The strains at different elbow flexion angles within each model were compared, and the strains at elbow extension and at maximum elbow flexion were compared between the normal model and each elbow deformity model. However, in the cubitus varus model, the ulnar nerve deflected more than the measurable range of the strain gauge; elbow flexion of 60° or more were considered effective values. Statistical analysis of the strain values was performed with Friedman test, followed by the Williams’ test (the Shirley‒Williams’ test for non-parametric analysis). Results: In all models, ulnar nerve strain increased significantly from elbow extension to maximal flexion (control: 13.2%; cubitus valgus 10°: 13.6%; cubitus valgus 20°: 13.5%; cubitus valgus 30°: 12.2%; cubitus varus 10°: 8.3%; cubitus varus 20°: 8.2%; cubitus varus 30°: 6.3%, P < 0.001). The control and cubitus valgus models had similar values, but the cubitus varus models revealed that this deformity caused ulnar nerve relaxation. Conclusions: Ulnar nerve strain significantly increased during elbow flexion. No significant increase in strain 2 cm proximal to the medial epicondyle was observed in the cubitus valgus model. Major changes may have been observed in the measurement behind the medial epicondyle. In the cubitus varus model, the ulnar nerve was relaxed during elbow extension, but this effect was reduced by elbow flexion.博士（医学）・甲第865号・令和5年3月15

肩鎖関節の安定性における肩鎖靭帯の役割 : 新鮮凍結屍体を用いた生体力学的研究

Background: Acromioclavicular (AC) joint dislocation is evaluated using the radiologically based Rockwood classification. The relationship between ligamentous injury and radiological assessment is still controversial. Purpose/hypothesis: To investigate how the AC ligament and trapezoid ligament biomechanically contribute to the stability of the AC joint using cadaveric specimens. The hypothesis was that isolated sectioning of the AC ligament would result in increased instability in the superior direction and that displacement >50% of the AC joint would occur. Study design: Controlled laboratory study. Methods: Six shoulders from 6 fresh-frozen cadavers were used in this study. Both the scapula and sternum were solidly fixed on a customized wooden jig with an external fixator. We simulated distal clavicular dislocation with sequential sectioning of the AC and coracoclavicular (CC) ligaments. Sectioning stages were defined as follows: stage 0, the AC ligament, CC ligament, and AC joint capsule were left intact; stage 1, the anteroinferior bundle of the AC ligament, joint capsule, and disk were sectioned; stage 2, the superoposterior bundle of the AC ligament was sectioned; and stage 3, the trapezoid ligament was sectioned. The distal clavicle was loaded with 70 N in the superior and posterior directions, and the magnitudes of displacement were measured. Results: The amounts of superior displacement averaged 3.7 mm (stage 0), 3.8 mm (stage 1), 8.3 mm (stage 2), and 9.5 mm (stage 3). Superior displacement >50% of the AC joint was observed in stage 2 (4/6; 67%) and stage 3 (6/6; 100%). The magnitudes of posterior displacement were 3.7 mm (stage 0), 3.7 mm (stage 1), 5.6 mm (stage 2), and 9.8 mm (stage 3). Posterior displacement >50% of the AC joint was observed in stage 3 (1/6; 17%). Conclusion: We found that the AC ligaments contribute significantly to AC joint stability, and superior displacement >50% of the AC joint can occur with AC ligament tears alone. Clinical relevance: The AC ligament plays an important role not only in horizontal stability but also in vertical stability of the AC joint.博士（医学）・甲第810号・令和4年3月15日© The Author(s) 2021. This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/ licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions

ピエゾ型機械受容チャネル1による歯の発生過程におけるWNTシグナルと一次繊毛発現の調整

Signal transmission from the mechanical forces to the various intracellular activities is a fundamental process during tissue development. Despite their critical role, the mechanism of mechanical forces in the biological process is poorly understood. In this study, we demonstrated that in the response to hydrostatic pressure (HP), the piezo type mechanosensitive ion channel component 1 (PIEZO1) is a primary mechanosensing receptor for odontoblast differentiation through coordination of the WNT expression and ciliogenesis. In stem cells from human exfoliated deciduous teeth (SHED), HP significantly promoted calcium deposition as well as the expression of odontogenic marker genes, PANX3 and DSPP, and WNT related-genes including WNT5b and WNT16, whereas HP inhibited cell proliferation and enhanced primary cilia expression. WNT signaling inhibitor XAV939 and primary cilia inhibitor chloral hydrate blocked the HP-induced calcium deposition. The PIEZO1 activator Yoda1 inhibited cell proliferation but induced ciliogenesis and WNT16 expression. Interestingly, HP and Yoda1 promoted nuclear translocation of RUNX2, whereas siRNA-mediated silencing of PIEZO1 decreased HP-induced nuclear translocation of RUNX2. Taken together, these results suggest that PIEZO1 functions as a mechanotransducer that connects HP signal to the intracellular signalings during odontoblast differentiation

FGF2 SUPPRESSED CCL11 EXPRESSION IN HUMAN DENTAL PULP-DERIVED MSCs

The regulation of the mesenchymal stem cell (MSC) programming mechanism promises great success in regenerative medicine. Tissue regeneration has been associated not only with the differentiation of MSCs, but also with the microenvironment of the stem cell niche that involves various cytokines and immune cells in the tissue regeneration site. In the present study, fibroblast growth factor 2 (FGF2), the principal growth factor for tooth development, dental pulp homeostasis and dentin repair, was reported to affect the expression of cytokines in human dental pulp‑derived MSCs. FGF2 significantly inhibited the expression of chemokine C‑C motif ligand 11 (CCL11) in a time‑ and dose‑dependent manner in the SDP11 human dental pulp‑derived MSC line. This inhibition was diminished following treatment with the AZD4547 FGF receptor (FGFR) inhibitor, indicating that FGF2 negatively regulated the expression of CCL11 in SDP11 cells. Furthermore, FGF2 activated the phosphorylation of p38 mitogen‑activated protein kinase (p38 MAPK), extracellular signal‑regulated kinase 1/2 (ERK1/2) and c‑Jun N‑terminal kinases (JNK) in SDP11 cells. The mechanism of the FGFR‑downstream signaling pathway was then studied using the SB203580, U0126 and SP600125 inhibitors for p38 MAPK, ERK1/2, and JNK, respectively. Interestingly, only treatment with SP600125 blocked the FGF2‑mediated suppression of CCL11. The present results suggested that FGF2 regulated the expression of cytokines and suppressed the expression of CCL11 via the JNK signaling pathway in human dental pulp‑derived MSCs. The present findings could provide important insights into the association of FGF2 and CCL11 in dental tissue regeneration therapy

Elevated Serum BAFF Levels in Patients with Localized Scleroderma in contrast to other organ-specific autoimmune diseases

Serum levels of B-cell activating factor belonging to the tumor necrosis factor family (BAFF), a potent B-cell survival factor, are elevated in patients with systemic autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis and systemic sclerosis (SSc). The objective of this study was to determine serum BAFF levels and relate the results to the clinical features in patients with organ-specific autoimmune diseases of the skin, such as localized scleroderma and autoimmune bullous diseases. Serum BAFF levels were examined by enzyme-linked immunosorbent assay in 44 patients with localized scleroderma, 20 with pemphigus vulgaris/pemphigus foliaceus, 20 with bullous pemphigoid and 30 healthy controls. Twenty patients with SSc and 20 with SLE were also examined as disease controls. Serum BAFF levels were elevated in localized scleroderma patients compared with healthy controls. Concerning localized scleroderma subgroups, patients with generalized morphea, the severest form of localized scleroderma, had higher serum BAFF levels than linear scleroderma or morphea patients. The BAFF levels of generalized morphea were comparable with those of SSc or SLE. Furthermore, serum BAFF levels correlated positively with antihistone antibody levels and the severity of skin lesion as well as the number of skin lesions. By contrast, serum BAFF levels were not significantly elevated in patients with pemphigus or pemphigoid. These results suggest that BAFF may be contributing to autoimmunity and disease development in localized scleroderma. © 2007 The Authors Journal compilation © 2007 Blackwell Munksgaard

Effect of tank shape on survival and growth of Pacific bluefin tuna Thunnus orientalis larvae

We examined the effect of rearing tank shape on survival and growth of Pacific bluefin tuna Thunnus orientalis larvae. Cylindrical (1.7 × 103 cm2 water surface area; 30 cm deep) and rectangular (1.8 × 103 cm2 water surface area; 28 cm deep) tanks (n = 3 each) were filled with 50 l of seawater. One air stone with a 100 ml/min aeration rate was set at the bottom center of each tank. Light intensity at the water surface was 2000 lx with a photoperiod of 24 L:0D. Larvae were introduced into each tank at a rate of 10 individuals/l at 2 days post-hatching (dph). Rotifers were fed at 10 individuals/ml and their distribution in tanks was measured. Survival of larvae in cylindrical tanks (CT; 52.7 ± 5.1%) at 8 dph was higher than that in rectangular tanks (RT; 0.8 ± 0.7%, p < .01). Meanwhile, larvae growth was not significantly different between tank shapes either in body length (CT: 4.23?±?0.26?mm; RT: 4.09 ± 0.20 mm) or dry weights (CT: 95.1 ± 17.6 μg; RT: 67.7 ± 10.9 μg). The swimbladder inflation rate of larvae also did not differ significantly between tank shapes (CT: 16.5 ± 14.5%; RT: 56.9 ± 3.47%). Rotifer distribution was higher at tank bottom in both shapes (p < .05). Two-phase bubbly flow simulations in the tanks revealed that the low-flow area was larger in the RT. The low-flow area at tank bottom varied by tank shape, occurring at the edge of the tank wall on the bottom in the CT, and from the center of the tank (air stone) to the tank wall in the RT. These low-flow areas at tank bottom coincided with areas of higher rotifer distribution, which may be a cause of sinking syndrome in fish larvae. Our results indicate that small-scale (50-l) PBT larviculture experiments can be conducted using a CT with the present aeration system, and that an RT requires an improved aerator in place of the single air stone